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ICAR SINONASAL TUMORS

TABLE XXII.C.1 (Continued)

Clinical endpoints

Study

Year LOE Study design Study groups

Conclusion

Unsal et al. 1200

DSS

Surgical resection associated with improved DSS.

Patients with sinonasal ACC treated with either surgery, RT, or surgery and adjuvant RT ( n = 694) patients treated with surgical resection and adjuvant RT or combination of RT and chemotherapy ( n = 25) patients treated with surgical resection or RT/CRT ( n = 35) Sinonasal ACC Sinonasal ACC patients treated with surgical resection or RT/CRT ( n = 35) Surgical resection with adjuvant RT versus RTaloneas Sinonasal ACC

2017 4

Retrospective, population based cohort study

Michel et al. 408

2013 4

Retrospective case series

OS

Treatment with surgery and adjuvant RT is associated with improved 5-year survival compared to patients treated by exclusive RT or concomitant CRT 1. Adjuvant RT decreases local recurrence rates 2. Significant predictors for worse survival were T stage and distant metastasis Negative surgical margins improve local control rates

Rhee et al. 1198

1. OS 2. Local control

2006 4

Retrospective case series

Wiseman et al. 377

2002 4

Retrospective case series

1. OS 2. DFS

Naficy et al. 1203

OS

Surgery with adjuvant therapy group had better survival outcome than RT only, though this was not significant

1999 4

Retrospective case control

treatment for patients with sinonasal ACC ( n = 17)

Pitman et al. 1204

1999 4

Retrospective case series

Sinonasal ACC

DFS

Local recurrence after surgery is associated with poor prognosis

patients treated with surgery with adjuvant RT ( n = 35)

Abbreviations: ACC, adenoid cystic carcinoma; CRT, chemoradiation therapy; DFS, disease-free survival; DSS, disease-specific survival; OS, overall survival; RT, radiation therapy.

series of 19 patients, several factors were identified to be associated with poorer DSS including high mitotic count, recurrent disease, high tumor grade, and higher tumor stage. 1218 Modality of treatment and treatment sequence were not shown to significantly impact survival. 1217 2 Acinic cell carcinoma Acinic cell carcinoma (AciCC) is also a rare, epithelial sali vary gland-based malignancy with documented primary involvement in the paranasal sinuses and nasal cavity. In 2014, Biron et al. published the largest study to date of sinonasal AciCC by utilizing the SEER database analyz ing demographic, tumor characteristic, and survival data from 18 patients from 1973 to 2009. 1220 At the time of that

publication, there had been only 19 prior cases of sinonasal AciCC reported in the English language literature in the form of primarily case reports. The mean age of diagno sis was 56.2 years, and most patients were White (77.8%). There was no sex predilection, although 61% of patients were female when looking at the previous case reports. All tumors from the Biron et al. study were classified as either T1 or T2 stage, with no cases with nodal or dis tant metastases. All tumors were histologically noted to be low grade. The most common subsite identified was the nasal cavity (50%), followed by the ethmoid sinus (22.2%), accessory sinus not otherwise specified (16.6%), maxillary sinus (5.6%), and overlapping lesions of the ethmoid and maxillary sinus (5.6%). Surgical intervention was the primary offered treatment in 81.3% of cases with 18.7% also undergoing adjuvant RT.